What is the differential diagnosis (DDX) for alopecia in a 14-year-old female?

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Differential Diagnosis for Hair Loss in a 14-Year-Old Girl

Single Most Likely Diagnosis

  • Telogen Effluvium: This condition is characterized by excessive hair shedding, often triggered by hormonal changes, stress, or nutritional deficiencies. It's a common cause of hair loss in adolescents, especially during puberty when hormonal fluctuations are significant.

Other Likely Diagnoses

  • Alopecia Areata: An autoimmune condition leading to patchy hair loss, which can be triggered by stress or hormonal changes. It's relatively common in teenagers.
  • Androgenetic Alopecia (Female Pattern Hair Loss): Although less common in young teenagers, it can start during puberty, especially if there's a family history.
  • Traction Alopecia: Caused by hairstyles that pull on the hair, such as tight braids, ponytails, or cornrows, leading to hair loss, particularly around the hairline.
  • Nutritional Deficiencies: Deficiencies in iron, zinc, biotin, or vitamin D can lead to hair loss. Given the dietary habits and potential for nutritional deficiencies in teenagers, this is a plausible cause.

Do Not Miss Diagnoses

  • Hyperthyroidism or Hypothyroidism: Both conditions can cause hair loss, and while less common, missing a diagnosis of thyroid dysfunction could have significant health implications.
  • Polycystic Ovary Syndrome (PCOS): Characterized by hormonal imbalance, PCOS can lead to hair loss, among other symptoms like acne and irregular menstrual cycles. Early diagnosis is crucial for managing long-term health consequences.
  • Autoimmune Disorders (e.g., Lupus): Systemic lupus erythematosus and other autoimmune diseases can cause hair loss and have serious health implications if not diagnosed and treated properly.

Rare Diagnoses

  • Trichotillomania: A psychological disorder characterized by an irresistible urge to pull out one's own hair, leading to noticeable hair loss.
  • Tinea Capitis (Ringworm of the Scalp): A fungal infection that can cause hair loss, usually accompanied by other symptoms like redness, itching, and scaling of the scalp.
  • Congenital Conditions (e.g., Congenital Alopecia): Rare conditions present at birth that can cause hair loss.
  • Hair Loss Due to Medication: Certain medications can cause hair loss as a side effect. While rare, it's essential to consider if the patient is on any long-term medications.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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